1. Why is it important to find a lump or other breast abnormality early?
   
   If detected early, breast cancer can often be treated effectively with surgery that preserves the breast, followed by radiation therapy. This local therapy is often accompanied by systemic chemotherapy and/or hormonal therapy, depending on the size of the tumor and other factors. Five-year survival after treatment for early-stage breast cancer is greater than 98 percent.
   
   
2. I'm only 25—do I need to worry about breast cancer?
   
   Although it is rare, breast cancer can occur in women under 30. Make an effort to find out if breast cancer has occurred in any of your relatives. If so, speak to your health care professional about a plan of action. A typical plan includes periodic breast self-examinations, an examination by a health care professional at least every three years, and regular mammograms beginning at age 40. Breast cancer incidence increases with age. One out of eight invasive breast cancers occur in women younger than 45, while two out of three invasive breast cancers occur in women age 55 or older.
   
   
3. A friend told me her routine mammogram was "abnormal." What does this mean, and what should a woman do if she receives this type of report?
   
   Along with the increased use of mammography comes a greater chance that a woman will have a result that needs more study. Any mammogram with an abnormal report is cause for additional testing to determine the nature of the abnormality. It may not necessarily be cancer, but only more testing will tell you this for sure. Additional testing can involve more mammograms and possibly a biopsy of the abnormality.
   
   
4. My doctor said my mammogram was suspicious—what does that mean?
   
   Mammograms that are labeled as a "suspicious abnormality" mean there are signs that are suggestive of a cancer, such as an irregular mass, contraction of the tissue around it, groups of small calcifications, underarm lymph node involvement or thickening of the skin.
   
   
5. What could it be if it is not breast cancer?
   
   A frequent type of abnormality appears as calcifications, which are seen as white specks grouped in clusters or in strings on the films from your mammogram. Calcifications may or may not be caused by cancer. Clustered, small calcifications—called microcalcifications—alone are associated with an increased risk of cancer and therefore should be followed with more mammograms or a biospy. The way these calcifications are positioned within the breast, their number and shape can provide a radiologist with a suggestion of whether these should be left alone, or further examined for invasive or preinvasive disease. If your mammogram reveals a mass, one that is star-shaped or irregularly bordered is more suspicious than a round or smooth-edged mass, which is more likely to be a fluid-filled cyst.
   
   
6. My doctor ordered a second mammogram and it's still not clear. What next?
   
   After re-imaging or a follow-up mammogram, if unresolved concerns persist the next step is to learn more about the area in question. If a cyst is suspected, a sonogram (ultrasound) can often determine if a mass is a cyst that can be drained or is solid and requires a biopsy. Many biopsy options exist today, including image-guided core needle procedures that remove small quantities of tissue from the area in question and can be completed in a doctor's office.
   
   
7. How do I know if I'm at high risk of getting breast cancer?
   
   A woman is considered at higher risk for breast cancer if she has a mother, sister or daughter who has been diagnosed with breast cancer. About five to 10 percent of all breast cancers are hereditary, but a carrier of BRCA1/2 may have as high as an 80 percent chance of developing breast cancer and at a younger age than women who are not born with one of the mutations. Women with BRCA1/2 are also at an increased risk of developing ovarian cancer.
   
   
8. I have atypical hyperplasia. What does that mean?
   
   This type of noncancerous breast disease is characterized by a growth of abnormal cells within the breast ducts. Premenopausal women with a biopsy-confirmed diagnosis of atypical hyperplasia are at increased risk for later developing invasive breast cancer.
   
   
9. I have large breasts and I've been having a strange pain in one of them. Am I at risk of having breast cancer?
   
   There is no known correlation between breast size and cancer. Also, breast pain is very commonly due to noncancerous conditions and is not usually the first symptom of breast cancer. However, you should contact your health care professional about any unusual symptoms that persist.
   
   
10. I want to have breast reconstruction, but what about the horror stories about silicone implants?
    
    Today’s silicone-gel implants are stronger, thicker and safer than their predecessors, but there are various alternatives, including saline implants or using tissue from your abdomen or from other areas of the body to reconstruct a breast. Depending on your situation, you may even be able to have breast reconstruction at the time of mastectomy. But you would likely have to return to surgery if you wanted a nipple and areola added. Nowadays, however, you can have breast reconstruction as an outpatient, depending on your health and stage of cancer.
    
    

For more information on risk factors, diagnosis and treatment options for breast cancer, visit the HealthyWomen Health Center at http://www.healthywomen.org/healthcenter/breast.